Cetuximab

CLINICAL USE


Monoclonal antibody:

  • Treatment of EGFR-expressing metastatic colorectal cancer in combination with irinotecan after failure of irinotecan-including cytotoxic therapy

    DOSE IN NORMAL RENAL FUNCTION

    Initial dose 400 mg/m2 then 250 mg/m2 weekly

    PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :152 000
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :No data
  • %Excreted unchanged in urine &nbsp &nbsp : minimal
  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :1.5–6.2 L/m2
  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :70–100/unchanged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function. Use with caution
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function. Use with caution
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function. Use with caution

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR <10 mL/min

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux &nbsp :Not dialysed. Dose as in GFR <10 mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR=10–20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • None known

    ADMINISTRATION

    Reconstition

    Route

    IV infusion

    Rate of Administration

    1st dose: 120 minutes Further doses: 60 minutes Maximum infusion rate must not exceed 5 mL/min

    Comments

    Administer via a 0.2 micrometer in-line filterThe filter may clog and need to be replaced during the infusion

    OTHER INFORMATION

  • Delayed hypersensitivity reactions may occur and patients should be warned to contact their doctor if this occurs
  • Premedication with an antihistamine is recommended
  • 2% of patients receiving cetuximab developed renal failure
  • Give irinotecan at least 1 hour after the end of cetuximab infusion.